Endoscopic radial artery harvesting reduces postoperative pain and neurologic complications

Heart Surg Forum. 2007;10(5):E363-5. doi: 10.1532/HSF98.20071105.

Abstract

Background: Endoscopic radial artery harvest provides better cosmetic result without compromising the quality of the graft. We sought to compare postoperative harvesting site neurologic and vascular outcome.

Methods: From 10/2002 until 10/2004, 50 patients were randomized to have their radial artery harvested for coronary bypass either endoscopically (group A, n = 25) or conventionally (group B, n = 25). Radial arteries were preoperatively evaluated by Doppler echocardiography. Neurologic and functional status was assessed by a self reporting questionnaire with a semiquantitative (1-5) scale. Vascular status of the forearm was assessed by control echocardiography.

Results: At an average follow-up of 37 +/- 7 months, patients undergoing endoscopic radial artery harvesting had less overall neurologic complications (11 versus 17 patients, P = .023) and they were less severe (0.8 +/- 1.1 versus 2.2 +/- 1.2; P < .001). Ulnar flow increase was similar among the groups: 13.1 +/- 5.43 cm/s in group A versus 15.9 +/- 4.9 cm/s in group B (P = .147) as well as ulnar artery diameter increase 0.29 +/- 0.16 mm in group A versus 0.29 +/- 0.26 cm in group B (P = .914).

Conclusion: Endoscopic radial artery is safe and does not compromise graft quality or forearm and hand circulation postoperatively. Along with providing a better cosmetic result, endoscopic artery harvesting reduces postoperative harvesting site pain and neurologic complications.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Blood Flow Velocity
  • Coronary Artery Bypass / methods*
  • Echocardiography, Doppler
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control*
  • Radial Artery / diagnostic imaging
  • Radial Artery / surgery*
  • Radial Artery / transplantation
  • Ulnar Artery / diagnostic imaging